癌症的艾弗·易斯食道切除术之前的胃调节:来自Apil_2013试点随机对照试验的长期结果
Kristel Mils1, Mònica Miró1, Esther Alba2
1Esophageal Surgery Unit, Surgery Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Universitat de Barcelona (UB), Barcelona, Spain.
The Journal of surgical research
|August 17, 2025
概括
消化管切除术前的胃缺血条件 (GIC) 与单独的手术相比,显示出类似的长期存活率和复发率. 然而,避免胃管衰竭显著改善食道癌症患者的整体存活率.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
背景情况:
- 胃缺血条件 (GIC) 与癌症的艾沃尔·易斯食道切除术中更好的短期结果有关.
- GIC可能会降低静脉漏 (AL) 的发生率和严重程度.
- GIC对食道手术结果的长期影响需要进行调查.
研究的目的:
- 评估GIC对食道手术后的结果的长期影响.
- 在一项随机试验中,将GIC与单独的手术 (SA) 进行比较.
主要方法:
- 进行了一项随机的,单中心的,受控的,并行组的试验试验.
- 两个组进行了比较:在Ivor Lewis食道切除术之前的GIC与SA.
- 主要终点:静脉狭窄;次要终点:口服,重建性手术,慢性AL,气道抽,死亡率,整体存活率 (OS) 和1,3,5年复发率.
主要成果:
- 在这两组中都没有观察到动脉狭窄.
- 口服的成功率为90% (GIC) 和72.2% (SA) (P=0.222).
- 总体存活率 (55%对36%) 和无病存活率 (50%对36.8%) 是可比的,复发率也是如此. 没有胃管衰竭的患者的生存率明显更好 (P=0.018).
结论:
- 长期的结果包括静脉狭窄,慢性AL,存活率和复发率在GIC和SA组之间是相似的.
- 胃管衰竭会对食道手术后的整体存活率产生负面影响.
- GIC似乎不会显著改变长期存活率或复发率,但避免管道故障至关重要.
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